HOW TO APPLYApplication forms (3 pages) are available at the Band Office and clinics in Wabaseemoong and Grassy Narrows. You can also contact the Mercury Disability Board office for forms.

Please fill out the application then request the Chief of your community (Grassy Narrows or Wabaseemoong) complete and sign the Band Statement section of the application form. Submit the completed and signed application form to the Board Representative in your community or directly to the Mercury Disability Board office.

These forms are sent to the Mercury Disability Board to begin the claims process with the Great West Life Assurance Company. Great West Life administers the claims process and the Mercury Disability Fund on behalf of the Mercury Disability Board. A medical examination will then be arranged for you. The results of your examination and outcome recommendation is made according to the prescribed process and forwarded to Great West Life, the administrator, to determine if an award is payable.

If your claim is approved, a monthly benefit amount is sent to you by mail or bank direct deposit. If your claim is denied, you will be advised in writing of the reasons for the denial.

HOW TO RE-APPLYAfter a two year period from your last assessment if your symptoms have changed, you are eligible to re-apply.

Re-application forms (1 page) are available at the Band Offices and Clinics in Wabaseemoong and Grassy Narrows or directly from the Mercury Disability Board office.

To file a re-application, you will need to complete a re-application form. You then forward your completed re-application to the Board Representative in your community or directly to the Mercury Disability Board office.

Once the form is received at the Mercury Disability Office and eligibility for a re-application has been confirmed (2 year period), you will then be scheduled for a subsequent medical examination.

The results of your examination and recommendation are forwarded to Great West Life who will review your re-application examination and determine if an award is payable.

If your re-application is approved, a monthly benefit amount is sent to you by mail or bank direct deposit.

If your claim is denied, you will be advised in writing of the reasons for the denial.

NEUROLOGICAL ASSESSMENT INFORMATIONDuring examination, the following conditions are looked for and the examination shows how severe they are:

Tremor – an involuntary movement.

Ataxia – lack of coordination and/or trouble walking.

Incoordination – lack of ability to coordinate the actions of muscles and how it interferes with what you are able to do.

Visual Field Constriction – decrease in the area within which objects may be seen when the eye is fixed (looking forward).

ScoringNeurological exams are point scored according to the degree of impairment due to the conditions noted above. The minimum point score to entitle an applicant to benefits is 6 points with a benefit of $250/month.

HISTORYIn 1985, Wabaseemoong Independent Nations and Grassy Narrows First Nation negotiated a settlement with the federal government, the province of Ontario, and two paper companies for all claims due to mercury contamination in the English and Wabigoon river systems. In 1986, both the federal government and the province enacted legislation to carry out the terms of the settlement.

One part of the settlement provided for the establishment of a Mercury Disability Fund and a Mercury Disability Board. Another component was funds paid to the First Nations in 1985.

Members of Wabaseemoong Independent Nations and Grassy Narrows First Nation whose health may have been affected by mercury poisoning in the English and Wabigoon river systems may be entitled to an award from the Mercury Disability Fund.

The Mercury Disability Board supervises the administration of the Fund and oversees a claims process that is available to all Wabaseemoong and Grassy Narrows band members.

If you are a member of either community, are experiencing the neurological signs described in this pamphlet, and believe that you may be affected by mercury contamination from the English and Wabigoon River systems, you may be eligible for benefits.

IF YOU WOULD LIKE FURTHER INFORMATION ON HOW TO APPLY AND/OR RE-APPLY, OR FOR ANY MATTER RELATED TO THE MERCURY DISABILITY BOARD CLAIMS PROCESS PLEASE CONTACT THE MERCURY DISABILITY BOARD OFFICE.

Mercury Disability Board

P.O. Box 621Kenora, Ontario P9N 3X6

Phone: 807-466-3146Fax: 807-467-3202

Eligibility to Apply for Benefits

For a person to be eligible to apply for benefits (per legislation), that person must be a current member of Grassy Narrows First Nation or Wabaseemoong Independent Nations; a past member of one of the two bands; or a registered Indian who was customarily resident on one the two first nation communities prior to the first day of October 1985

Did you know...

that since inception to March 31, 2017 the Mercury Disability Board has processed 1093 initial applications for benefits.